Recently, phacoemulsification is a widely used technique gor extraction of opaque lens. Phacoemulsification thorugh a small incision prvides early visual rehabilitation. However, the side effects of phacoemulsification such as endothelial cell loss have been reported continuously. The aim of this study was to analyze the influence of incision site on corneal endotheliu. Central corneal endothlial cell loss(ECL) was compared following insertion of posterior chamber PMMA intraocular lens with 5.5mm superior scleral pocket incision in 30 eyes and 5.5mm temporal scleral poket incision in 31 eyes. Cell density of the corneal endothelium in all eyes was examed by auto-focus Non Contact Specular Microscopy preoperatively and 2 months postoperatively. The average cell loss was 7.41+/-6.9% and 6.61+/-7.1%, respectively. Phacoemulsification with temporal 5.5mm scleral pocket incisions produced slightly less endothelial cell loss(ECL) than superior incisions. But, there was no statistically significant difference between the eyes with temporal 5.5mm scleral pocket incisions and those with superior 5.5mm scleral pocket incisions. The endothelial cell loss(ECL) is not associated with the direction of corneal incision. If the appropriate direction of corneal incision is chosen by pre-poerative corneal astigmatism, it seems that we will find the better results.
Astigmatism ; Cell Count ; Endothelial Cells* ; Endothelium, Corneal ; Lenses, Intraocular ; Microscopy ; Phacoemulsification* ; Polymethyl Methacrylate ; Rehabilitation

To examine the stability in the bag in foldable silicone IOL implantation and determine its effect on visual acuity. This study comprised 66 eyes that had phacoemulsification with three-piece foldable silicone intraocular lens(IOL) implantation that were prospectively evaluated about 2 months after surgery. The examination included the status of the haptic and optic placement, extent of posterior capsular capsular opacification(PCO), and the best corrected visual acuity. Sixty-five eyes had an in-in haptic placement, one eye had in-out placement, and there was no eye in out-out placement. Capsular capture occurred in 13 eyes(19.70%). The extent of POC in eyes with capsular capture was greater than in those withot capture. But the best corrected visual acuity in eyes with capsular capture made no difference to those without capture. In addition, eyes with in-out and out-out haptic placement had worse PCO than the eyes with in-in placement. There was a high incidence of capsular capture after silicone IOL implantation. This complication, along with the undesirable placement of the haptics, led tod PCO and was anticipated visual inpairment in long term follow-up. Therefore proper amount of continuous curvilinear capsulorhesix opening and complete placement of lens in the bag ahould be necessary.
Follow-Up Studies ; Incidence ; Lenses, Intraocular* ; Phacoemulsification ; Prospective Studies ; Silicones* ; Visual Acuity

No abstract available.
Hemangioma*

PURPOSE: To evaluate the effectiveness and safety of combined phacoemulsification, pars plana vitrectomy and IOL implantation in non-diabetic patients, and to compare the clinical results with that of sequential surgery. METHODS: The results of combined phacoemulsification, pars plana vitrectomy and IOL implantation in 15 patients (15 eyes) were retrospectively analyzed. Major outcome measures were pre-and postoperative best-corrected visual acuity (BCVA), postoperative BCVA 0.5 or better, and postoperative complications. Comparison between the combined surgery in 12 eyes and sequential surgery in 9 eyes were also analyzed for the same outcome measures. RESULTS: Of the 15 eyes postoperative visual acuity improved in 14 eyes (93.3%), and BCVA 0.5 or better was achieved in 6 eyes (40.0%). Of the 15 eyes postoperative complications consisted of transient IOP increase in 8 eyes (53.3%), hyphema in 4 eyes (26.7%), retinal detachment in 3 eyes (20.0%), vitreous hemorrhage in 2 eyes (13.3%), anterior chamber fibrin exudation in 2 eyes (13.3) and posterior capsular rupture in 2 eyes (13.3%). The difference in complications between the combined surgery group and sequential surgery group were not statistically significant. CONCLUSION: Combined surgery in selected patients is a safe and effective approach, and the outcome is comparable to sequential surgery.
Anterior Chamber ; Fibrin ; Humans ; Hyphema ; Outcome Assessment (Health Care) ; Phacoemulsification* ; Postoperative Complications ; Retinal Detachment ; Retrospective Studies ; Rupture ; Visual Acuity ; Vitrectomy* ; Vitreous Hemorrhage

In order to determine the factors affecting the length of stay by pay status, a total of 961 in-patients medical records with appendectomy, cholecystectomy and Cesarean section discharged from the January 1979 to December 1981 from the University hospital were reviewed. Average length of stay showed no statistically significant difference by year between the insured and the non-insured patients, however multiple diagnoses and surgical complication were significantly different from single diagnosis and non-complicated cases. Surgical complication explained the length of stay mostly, and physician in discharge, multiple diagnoses, and accommodation in order for insured patients. Surgical complication, admission route, physician in charge and age in order explained the length of stay for non-insured patients.
Appendectomy ; Cesarean Section ; Cholecystectomy ; Diagnosis ; Female ; Humans ; Length of Stay* ; Medical Records ; Pregnancy

OBJECTIVES: To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. METHODS: A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer? ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. RESULTS: The 5 dimensions were as follows ; 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness. A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. CONCLUSIONS: The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.
Consumer Satisfaction ; Cross-Sectional Studies ; Delivery of Health Care ; Factor Analysis, Statistical ; Gyeonggi-do ; Hospitals, General ; Humans ; Outpatients* ; Quality Improvement ; Quality of Health Care ; Surveys and Questionnaires ; Reproducibility of Results

OBJECTIVE: Infliximab, a monoclonal antibody to tumor necrosis factor-alpha, is effective in patients with ankylosing spondylitis (AS), who have not responded to conventional therapy. There were no data on the efficacy and side effect of infliximab in patients with AS in Korea. The objective of this study is to observe the efficacy and adverse effect of infliximab retrospectively in Korean patients with AS. METHODS: We reviewed the medical records of thirty-three AS patients. The patients were enrolled to fulfill the modified New York criteria of AS and be in active disease state and resist to conventional therapy. Patients were given 3~5 mg/kg of infliximab infusions at weeks 0, 2, 8 and 16. Information on C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and antinuclear antibody (ANA) test was collected at each infusion. The paired t-test was used for comparison between the visits. RESULTS: There were 29 male and 4 female patients. The mean age at first infliximab treatment was 34.6+/-9.8 years. All patients were HLA-B27 positive. ESR and CRP decreased significantly from baseline to 16 weeks after treatment (p<0.001, respectively). The mean ESR was 76.1+/-36.5 mm/h at baseline and 21.3+/-31.6 mm/h at 16 weeks. The mean CRP was 6.4+/-4.8 mg/dL at baseline and 1.3+/-2.1 mg/dL at 16 weeks. Only 1 out of 33 patients got worse. All patients were tested negative for ANA at baseline. After 16 weeks of therapy, the induction of ANA was observed in 8 patients, but no patients have lupus-like symptoms. CONCLUSION: Infliximab is an effective therapy with non-specific adverse effect in AS non-responsive to conventional therapy in Korea.
Antibodies, Antinuclear ; Blood Sedimentation ; C-Reactive Protein ; Female ; HLA-B27 Antigen ; Humans ; Infliximab ; Korea ; Male ; Medical Records ; Retrospective Studies ; Spondylitis, Ankylosing* ; Tumor Necrosis Factor-alpha

Carcinoma of the gallbladder is relatively rare malignancy usually found in an elderly, predominantly female population. Histologically, adenocarcinoma predominate, with only 10% to 15% being of other varieties(small cell carcinoma and others). Small cell carcinoma of the gallbladder is a rare lesion and predominantly a disease of older women with clinical history of stones. These tumors show an aggressive clinical course and death usually occurs with in a few months of the diagnosis. The diagnosis of small cell carcinoma should be based on cell morphology, histologic pattern and immunohistochemical study. Correct diagnosis is important not only because these tumors give rise to endocrine syndromes, but also because the chemotherapeutic approach to small cell carcinoma differs from that for adenocarcinoma.
Adenocarcinoma ; Aged ; Carcinoma, Small Cell* ; Diagnosis ; Female ; Gallbladder* ; Humans

BACKGROUND: Tuberculosis is still one of the most seriously threatening infections in Korea, because of multidrug resistant tuberculosis. Results of antituberculosis drug susceptibility test can provide clinicians very important informations for selection of proper regimens for treatment. METHODS: In this study the results of antituberculosis drug susceptibility test of 298 cases at Kyunghee Medical Center from 2000 to 2003 were retrospectively analysed to evaluate the trend of antituberculosis drug susceptibility. The procedure of drug susceptibility test was based on the absolute concentration method using Lowenstein-Jensen solid media. RESULTS: The resistance rate of Mycobacterium tuberculosis to one or more drugs was increased from 29.3% in 2000 to 48.2% in 2003, and the rates of multiple resistance to two or more drugs increased from 13.3% in 2000 to 20.5% in 2003. The increase in resistance rate to individual drug during study period were 20.0% to 24.1% in isoniazid, 9.3% to 19.3% in rifampicin, 5.3% to 15.7% in ethambutol, 4.0% to 10.8% in para-aminosalicylic acid, 2.7% to 6.0% in kanamycin, 1.3% to 7.2% in ethionamide, 1.3% to 6.0% in capreomycin, 1.3% to 7.2% in prothionamide, 0.0% to 12.1% in ofloxacin, 6.7%to 3.6% in streptomycin, 6.7% to 7.2% in cycloserine, 10.7% to 8.4% in pyrazinamide, respectively. CONCLUSIONS: The resistance rate of M. tuberculosis has been increased with years and multidrug resistant M. tuberculosis was commonly encountered in the specimens from the patients visited Kyunghee Medical center.
Aminosalicylic Acid ; Capreomycin ; Cycloserine ; Ethambutol ; Ethionamide ; Humans ; Isoniazid ; Kanamycin ; Korea ; Mycobacterium tuberculosis ; Ofloxacin ; Prothionamide ; Pyrazinamide ; Retrospective Studies ; Rifampin ; Streptomycin ; Tuberculosis

BACKGROUND: Bleeding peptic ulcer is the most common cause of upper gastrointestinal bleeding. Various different endoscopic hemostatic methods were introduced to treat bleeding peptic ulcer. Many studies reported the efficacy and comparision of various methods. Endoscopic injection therapy is the most comman method among them because it is inexpensive and easy in use. Complications of injection therapy such as aggravation of bleeding, tissue neerosis and perforation were repoted rarely. Recently endoscopic hemoclipping method is considered to be safe and effective hemostatic method for upper gastrointestinal bleeding. METHODS: During the period between January 1993 and August 1996, we have conducted clinical trial and retrospective analysis among 100 patients in whom active bleeding or visible vessel was identified. RESULTS: 1) Three groups was divided, Hemoclip group 26 cases, Hypertonic Saline Epinephrine(HSE) group 59 cases, Combination group 15 cases. 2) The sources of bleeding in Hemoclip group were gastric ulcer in 23 Cases and duodenal ulcer in 3 cases, and in HSE group, gastric ulcer in 44 case, duodenal ulcer 14 cases and stomal ulcer in one case, and in combination group, gastric ulcer in 10 cases, duodenal ulcer in 3 cases and stomal ulcer in two cases. HSE and combination method were performed more than Hemoclip method in duodenal ulcer(23.7% and 20.0% versus 11.5%). 3) As the stigmata of bleeding in Hemoclip and HSE and Combination group, spurting were seen in 5 cases and 3 cases and 4 cases, and oozing in 10 cases and 17 cases and 3 cases, and nonbleeding visible vessel in 11 cases and 39 cases and 8 cases, respectively. Hemoclip method was performed more than HSE method in active bleeding state(57.6% versus 33.9%). 4) Initial hemostasis was achieved in 24 cases(92.3%) in Hemoclip group and 52 cases(88.1%) in HSE group, 13 cases(86.7%) in Combination group. 5) The rebleeding developed in 1 case(4.2%) in Hemoclip group and 8 cases(15.4%) in HSE group and 1 case(7.6%) in Combination group, the emergent operation was undewent 2 cases(7.7%) in Hemoclip group and 10 cases(17.0%) in HSE group and 1 case(6.7%) in Combination group, respectively. 6) The death was noticed in 1 cases(3.9%) in Hemoclip group and 2 cases(3.4%) in HSE group and 2 case(13.3%) in Combination group, repectively. 7) Permanent hemostasis by only endoscopic treatment was achieved in 24 cases(92.3%) in Hemoclip group and 48 cases(81.4%) in HSE group, 12 cases(80.0%) in Combination group. 8) Complication was noticed only in HSE group, aggravation of bleeding in one case and hematoma in two cases. CONCLUSION: Hemoclip method was effective hemostatic method same as HSE injection method, and safe method weth low complication in bleeding peptic ulcer. We suggest more detail selection of endoscopic hemostatic method in variously individualized endoscopic features.
Christianity ; Duodenal Ulcer ; Epinephrine* ; Hematoma ; Hemorrhage* ; Hemostasis ; Humans ; Peptic Ulcer* ; Retrospective Studies ; Stomach Ulcer ; Ulcer